Meta-analysis of single-case treatment effects on self-injurious behavior for individuals with autism and intellectual disabilities

Background and aim Research has demonstrated that a variety of treatments can reduce or eliminate self-injurious behavior (SIB) in individuals with autism and/or intellectual disabilities but evidence suggests that not all treatments are equally effective. Methods We used multi-level meta-analysis to synthesize the results of 137 single-case design studies on SIB treatment for 245 individuals with autism and/or intellectual disabilities. Analyses compare the effects of various behavioral and medical treatments for SIB and assess associations between treatment effects and participant- and study-level variables. Results Findings suggest differential reinforcement, punishment, and treatment packages with reinforcement and punishment components resulted in the largest SIB reductions. Conclusions Results indicate that overall, treatment for SIB is highly effective and that participant and study characteristics do not moderate treatment effects. Implications Based on results and in line with current practice recommendations, we encourage use of reinforcement-based procedures in all cases of SIB. In the event that reinforcement-only treatments have failed or if SIB poses a serious, immediate threat to the health and well-being of an individual, our results suggest that overcorrection paired with reinforcement may be the most effective as well as less invasive alternative.